Search

Objective: Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomic screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with careful examination. Material and Methods: This was a descriptive study of retrospective data that were obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department. The study was based on a chart review and only abnormalities that were diagnosed before the 16th week were included. Results: Two hundred forty-four first trimester pregnancy terminations were performed. In total, 273 anomalies were detected in the 244 patients. Cranial NTD comprised 32% of all anomalies (n=89). Fifteen percent of anomalies (n=41) needed detailed anatomic scanning for early diagnosis. Conclusion: In this study, we presented the number and percentage of our early diagnosed anomalies by years, as well showed our diagnostic performance for specific anomalies such as atrioventricular septal defect during a 5-year period. The study provides valuable information for future studies in Turkey and shows the need for an anatomic scan protocol while performing aneuploidy screening during early gestation. © 2018 by the Turkish-German Gynecological Education and Research Foundation.

Objective: To determine the effect of laparoscopic reversal of tubal sterilization on pregnancy rate. Methods: Eight patients who underwent laparoscopic tubal reversal between March 1999 and 31 December 2001 were evaluated. Results: Four of eight patients who had had laparoscopic tubal reversal became pregnant. Three have delivered; pregnancy in the fourth woman is ongoing. To date, the other four patients are still not pregnant. Two of these four cases have tubal patency but have not achieved pregnancy; in the other two cases, the operation was unsuccessful and tubal patency did not occur. Conclusion: In our preliminary study, the pregnancy rate was 50%.

PubMedID: 11173019 Study Objective: We documented such menstrual disorders as dysfunctional uterine bleeding (DUB): dangerous health problem during adolescence. Design, Setting, Participants: We gave a questionnaire containing 29 questions about menstruation to 3000 secondary school students in Adana, Turkey. Results: The mean age of the students was 15.8 years; their menarche age was 12.9 years. Irregular periods were observed in 26.7% of the cases, 62.2% had at least one irregular bleeding in their lives, 11.3% visited a gynecologist for irregular bleeding, and 4.5% were treated for it. Dysmenorrhea occurred in 38.7% of the students. Forty-one percent used pain killers during their menstruation; half of them received the drugs from their family, and the other half received them over-the-counter without a prescription. Almost half (46.6%) of the girls experienced premenstrual problems. Most of the students (71.4%) discussed their menstrual problems with their mothers. Among the school girls, 15.8% claimed that there was a correlation between school examinations and irregular menses. Conclusion: The questionnaire's results show that such menstrual disorders during adolescence as DUB are common but neglected. Medical staff who specialize in adolescent gynecology must address the problem.

Vulvovaginal candidiasis (VVC), particularly the recurrent form, remains an intractable problem for clinicians, microbiologists, and patients. It is essential to confi rm the clinical diagnosis by mycological methods and avoid empirical therapy. The recovery of yeast in fungal culture, such as on Sabouraud dextrose agar, remains the gold standard for diagnosis. In this investigation, we examined 474 participants, including 122 (25.7%) with acute VVC cases, 249 (52.5%) who had recurrent VVC (RVVC) cases, and 103 (21.7%) healthy controls. We also administered a questionnaire to obtain information on patient lifestyle and medical, gynecological, and sexual history. In addition, we compared the performance of chromID Candida agar (CAN2) to CHROMagar Candida (CAC) and Sabouraud dextrose agar with gentamicin and chloramphenicol (SGC2). The yeasts were identifi ed by conventional methods including the germ tube test, microscopic morphology on cornmeal–Tween 80 agar, and the commercial API 20C AUX system. We detected yeasts in 60 of 122 (49.2%) patients with acute VVC cases, 110 of 249 (44.2%) with RVVC cases, and in 35 of 103 (34%) healthy controls ( P 0.07). A total of 205 samples were found to be positive for fungi (43.2%), of which 176 (85.9%) were monofungal, and 29 (14.1%) were polyfungal. In addition, 198 of these samples (96.6%) were positive on CAN2, 195 (95.1%) on CAC, 189 (92.2%) on SGC2, and 183 (89.3%) samples on all three ( P 0.17). The 234 yeast isolates recovered were C. albicans ( n 118), C. glabrata ( n 82), C. kefyr ( n 11), C. krusei ( n 9), C. lipolytica ( n 3), C. colliculosa ( n 2), C. parapsilosis ( n 2), C. pelliculosa ( n 2), C. tropicalis ( n 2), and other species of Candida ( n 3). Of the 29 polyfungal populations, 28 (96.6%) were detected in CAN2, 25 in (86.2%) CAC, and 25 (86.2%) on both ( P 0.35). Notably, we detected the high predominance of C. albicansC. glabrata (86.2%) in polyfungal populations. Briefl y, the detection of C. albicans after 24 h of incubation was easier on CAN2 (64.4%) than on CAC (25.4%). This study showed that CAN2 is a rapid and reliable medium for immediate identifi cation of C. albicans and for detecting polyfungal populations in vaginal specimens. We observed that the use of antibiotics, intrauterine devices, as well as, perineal laceration, short anovaginal distance ( 3 cm), and genital epilation in common areas are predisposing factors for RVVC ( P 0.001). In addition, we detected that the use of menstrual pad, using an (IUD), and having a history of childbirth increased the risk of both acute and recurrent VVC ( P 0.01), whereas the use of a daily pad and walking daily signifi cantly decreased the risk of both acute and recurrent VVC ( P 0.01).

Giriş: Yaşlı nüfusun artması ile birlikte yaşlı sağlığı ile ilgili eğitimler birçok tıp fakültesinin müfredatında yer almaya başlamıştır. Bu makalenin amacı, Çukurova Üniversitesi Tıp Fakültesi'nde ilk kez uygulanan “Yaşlı Bireye Multidisipliner Yaklaşım Modülü” ile ilgili öğrenci ve eğiticilerden alınan geribildirimleri değerlendirmektedir. Gereç ve Yöntem: Modül, Haziran 2007'de, 3.sınıf öğrencilerine uygulanmış ve modüle katılan 26 eğitmen ve 163 öğrenciden geribildirimler alınmıştır. Bulgular: Öğrencilerden alınan kapalı uçlu geribildirimlerin ortalaması 3.8±0.5 (5 üzerinden), eğitimcilerden alınan kapalı uçlu geribildirimlerin ortalaması ise 4.0±0.5 bulunmuştur. Eğiticilerin açık uçlu geribildirimlerinde, modülün yararlı olduğu ifade edilmiş ve bundan sonraki uygulamalar için ek önerilerde bulunulmuştur. Öğrencilerin açık uçlu geribildirimlerinde ise modülün genel olarak yararlı olduğu ancak ders yılı sonunun zamanlama açısından uygun olmadığı belirlenmiştir. Sonuç: İlk kez uygulanan bu modülün olumlu yönleri olduğu kadar geliştirilmesi gereken yönleri de bulunmaktadır ancak böyle bir modülün, her yıl alınacak geribildirimler ışığında geliştirilmesinin yarının hekimleri olarak yetiştirdiğimiz öğrencilerimizin, yaşlı bireylere yaklaşımlarını olumlu yönde etkileyeceği açıktır. Introduction: By the increase of elderly population, educations on the health of elderly have started to take place in the programs of several medical faculties. The aim of this article is to evaluate students and trainers feedbacks for the "Module of Multidisciplinary Approach to Elderly Individual" which was performed for the first time in Çukurova University Faculty of Medicine. Materials and Method: The module was performed to the 3rd class students in June 2007. Feedbacks were received from 26 trainers and 163 students. Results: The mean of score based on closed ended feedbacks for students was 3.8±0.5 (over 5) and it was 4.0±0.5 for trainers. Open ended feedbacks of trainers indicated that the module was beneficial and suggested additional applications. Open ended feedbacks of the students' indicated that the module was generally useful but end of the school term was not found to be an appropriate time for the application. Conclusion: This firstly performed module has favorable parts as well as parts requiring improvement. However, it is apparent that the approach of the medical students to elderly individuals will be affected positively by the module and this will be improved by the feedbacks every year.

To investigate the relationship between some thrombophilic parameters and pregnancy induced hypertension (PIH).The study took place at the Department of Obstetrics and Gynecology, Perinatology Unit, Faculty of Medicine, Cukurova University, Turkey, between January 2002 and December 2002. We evaluated 202 patients. Patients were divided into 2 groups: control group comprised 102 normotensive patients20 weeks of pregnancy without any medical or pregnancy related pathologies and the study group comprised 100 patients over 20 weeks of pregnancy with PIH. These hypertensive patients were divided into 6 sub-groups as follows: eclampsia, severe preeclampsia, preeclampsia, chronic hypertension plus superimposed preeclampsia, eclampsia, and hemolysis elevated liver enzymes and thrombocytopenia (HELLP) syndrome.In all cases, complete blood count, antithrombin III, protein S levels, factor V Leiden mutation, prothrombin 20210 mutation, methylenetetrahydrofolate reductase (MTHFR) 677 mutation and homocysteine levels were studied. Statistical analysis of the data was carried out using SPSS version 11.0 program. In comparing the 2 groups we used Mann-Whitney U tests. In comparing the PIH subgroups we used Kruskal-Wallis tests. The levels of p0.05 were accepted as statistically significant.Antithrombin III deficiency, protein C deficiency, hyperhomocysteinanemia were found to be associated with PIH groups. But protein S deficiency, and homozygote factor V Leiden mutation, prothrombin 20210, MTHFR 677 mutation were not found to be related with PIH.

To evaluate the prognostic factors affecting morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome cases.We retrospectively evaluated, 2245 cases who delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Turkey between January and December 2002. Ninety-three cases had severe preeclampsia, 26 cases eclampsia, 19 cases HELLP syndrome, and 6 cases with eclampsia and HELLP syndrome were included in this study. The pregnancy induced hypertension cases were evaluated retrospectively for socioeconomic status, obstetrical history, biochemical parameters, and maternal complications.The incidence of preeclampsia was 20.1% (453/2245), the incidence of severe preeclampsia, eclampsia, and HELLP syndrome was 6.4% (144/2245). These ratios are higher than that reported in the English literature. The complication rate was 38% in severe preeclampsia cases. Among the severe preeclampsia cases, 32 had eclampsia (22.1%), and 25 had HELLP syndrome (17.3%).The most important biochemical marker for maternal mortality is bilirubin levels. Maternal mortality was statistically higher in cases with jaundice. Also, there was a statistically significant relation between maternal complications and liver function tests, lactate dehydrogenase levels, and low platelet levels.

Amaç: Şiddetli preeklampsi, eklampsi ve HELLP Sendromu olgularında morbidite ve mortaliteyi etkileyen prognostik faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Bu çalışmada, Ç.Ü.T.F. Kadın Hastalıkları ve Doğum A.B.D.'da 01.01.2000 ve 31.12.2000 tarihleri arasında doğum yapan 2245 olgu retrospektif olarak incelendi. 93 olgu şiddetli preeklampsi, 26 olgu eklampsi, 19 olgu HELLP sendromu ve 6 olgu ise eklampsi + HELLP sendromu tanısı ile çalışmaya dahil edildi. Çalışmada gebeliğe bağlı şiddetli hipertansiyonu bulunan olgular sosyoekonomik düzey, obstetrik öykü, biyokimyasal parametreler ve maternal komplikasyonlar yönünden retrospektif olarak incelenmiştir. Bulgular: Çalışmamızda preeklampsi oranı %20.1 (453/2245) olarak belirlenmiş olup şiddetli preeklampsi, eklampsi ve HELLP sendromu oranı ise %6.4 (144/2245) olarak bulunmuştur. Bu oran batı toplumlarına ait literatürün çok üzerindedir. Şiddetli preeklampsili olgularda komplikasyon oranı %38 olarak bulunmuştur. Şiddetli preeklampsili olguların 32'sinde (%22.1) eklampsi, 25'inde (%17.3) HELLP sendromu görülmüştür. Sonuç: Maternal mortalite ile ilişkili en önemli biyokimyasal belirtecin bilirubin olduğu gözlenmiştir.(p=0.007) İkteri olan olguların maternal mortalitesi yüksek bulunmuştur. Ayrıca karaciğer fonksiyon testleri, LDH yüksekliği ve trombositopeni ile maternal komplikasyonlar arasında anlamlı ilişki olduğu saptanmıştır. Objective: The aim of this study is to evaluate the prognostic factors affecting morbidity and mortality in severe preeclampsia, eclampsia and Hellp syndrome cases. Materials and Methods: In this study 2245 cases who delivered in Çukurova University Faculty of Medicine Department of Obstetrics and Gynecology between 01.01.2000 and 31.12.2000 were evaluated retrospectively. Ninety -three cases had severe preeclampsia, 26 cases eclampsia, 19 cases HELLP syndrome and 6 cases with eclampsia and HELLP syndrome were included into this study. In this study the pregnancy induced hypertension cases were evaluated retrospectively for the socioeconomic status, obstetrical history, biochemical parameters and maternal complications. Results: In this study the prevalance of preeclampsia was 20.1% (453/2245), the prevalance of severe preeclampsia,eclampsia and Hellp syndrome was 6.4% (144/2245). These ratios are higher than the English literature. The complication rate was 38 % in severe preeclampsia cases. Among the severe preeclampsia cases 32 had eclampsia (22.1%) and 25 had Hellp syndrome (17.3%). Conclusion: The most important biochemical marker for the maternal mortality is bilirubin levels. The maternal mortality was statistically higher in the cases with jaundice. Also there was statistically significant relation between maternal complications and liver function tests, LDH levels and low platelet levels.

Amaç: Riskli gebelikler perinatal morbidite ve mortalitenin en önemli nedenlerindendir. Maternal yaş, parite, sosyal sınıf, etnik özellikler anne sağlığını ve bebek doğurmayı direkt etkileyen ve birbirleriyle ilişkili faktörlerdir. Bu faktörler çok sayıda gebelik komplikasyonunu da beraberinde getirir. Bu çalışmada sözkonusu faktörlerin gözden geçirilmesi planlanmaktadır. Gereç ve Yöntem: Bu çalışmada Ç.Ü.T.F. Kadın Hastalıkları ve Doğum Anabilim Dalı'nda 01.01.1996 - 31.12.1998 tarihleri arasında yatarak takip ve tedavileri yapılan 3398 gebe gözden geçirildi. Bulgular: Gebeler yaşlarına ve doğum (parite) sayısına göre 3 gruba ayrıldı. Ayrıca bu 3398 riskli gebe tanılarına göre 7 farklı risk grubunda toplandı. Yaş ve parite gruplarında; bu 7 farklı risk grubundaki hastalık insidansları araştırıldı. Yaş grupları arasında doğum şekli açısından anlamlı bir farklılık yoktu (P>0.05). Oysa parite grupları arasında doğum şekli açısından istatistiksel olarak anlamlı bir farklılık saptandı (P 36 yaş gebelerde sistemik hastalıklar ile anne açısından riskler oldukça fazla bulunmuştur. Bununla birlikte nulliparlarda fetus açısından riskler fazla iken, grandmultiparlarda sistemik hastalıklar ve anne açısından riskler fazla bulunmuştur. Sonuç: Gebelik ve doğum olayında yaş ve parite önemli risk faktörleridir. 36 yaş gebeler yüksek risk altındadır. Yüksek riskli gebeliklerde prenatal bakımda yakın takip şarttır ve anormalliklerin erken teşhisi önemlidir. Objective: This study is planned to analyze retrospectively the high risk pregnancies which are important perinatal mortality and morbidity cause. Maternal age, parity, social clas,etnicity are factors which influence directly. Maternal heath and delivery. These factors are related with pregnancy complications. Material and Method: This study was done Çukurova University Faculty of Medicine Depertmant of Obstetrics and Gynecology between 01.01.1996 and 31.12.1998 on 3398 high risk pregnant women Result: Patients were dividet to 3 groups for age and parity. These 3398 high risk pregnant women were divided in to 7 different risk groups. These 7 risk groups were investigated accerding to age and parity. There was not a statistically significant difference between the age groups regarding mode of delivery (P>0.05). However mode of delivery was statistically significantly different for the parity (36 years of age pergnants, systemic disease and maternal risk were higher. In the nulliparous pregnants fetal risks was higher and in grandmultiparous group systemic disease and maternal risk were higher. Conclusion: In Pregnancy and delivery age and parity are importand risk factors 36 years of aged pregnants have higher risk. In high rish pregnancies close prenatal care is important to diagnose the problems.

PubMedID: 11173020 Study Objective: We documented adolescent pregnancies that were thought to be at high risk for increased obstetric complications. Design, Setting, Participants: This study covered 442 pregnant women who were under 19 years of age and who delivered in Çukurova University, School of Medicine, Department of Obstetrics and Gynecology between January 1, 1993 and December 31, 1997, retrospectively. Results: The patients' mean age was 18.24 years and their mean gestational age was 38.2 weeks. The newborns' mean birthweight was 3093.05 g and their mean birth height was 45.75 cm. Apgar score in the 1st minute was 6.79 and at the 5th minute 8.37. Cesarean section rate was 28.5%. The most common causes were pregnancy-induced hypertension (PIH) and breech delivery. There were 32 stillborns and 5 early neonatal deaths. The most frequent obstetric complications were PIH (14.5%), preterm delivery (7.0%), and low birthweight < 2000 g) (10.2%). The pregnant adolescents with obstetric problems (44.4%) had poor obstetric results. Conclusions: Adolescent pregnancies are considered high risk with many obstetric complications and poor obstetric results. To decrease the complications adolescent pregnancies must be followed-up as high risk pregnancies, especially in developing countries where socioeconomic factors are more pronounced.